Rheumatoid Arthritis and College, a Guide to Academic Accommodations

If you are a college student with rheumatoid arthritis, the following article is addressed towards meeting your needs in the classroom through academic accommodations under section 504 of the Americans With Disabilities Act.

Having been diagnosed with RA while in a Master's program, I know first-hand the difficulties the disease can bring to studies. I have also taught college, and plan to become a full-time professor after completing my PhD. I hope to impart not just useful information to fellow students with RA, but also some perspective picked up along the way.

How to qualify

Find the Center for Disability Services or similarly named division on campus and schedule an appointment with a counselor.

The following is the definition of what qualifies according to the Americans with Disabilities Act Section 504:

1. You have a physical and/or mental impairment that substantially limits one or more major life activities, including, but not limited to, caring for yourself, performing manual tasks, seeing, hearing, eating, sleeping, walking, standing, lifting, bending, speaking, breathing and working. Major life activities may also include school-related tasks such as learning, reading, concentrating, thinking, and communicating. Major life activities also include the operation of “major bodily functions,” including, but not limited to, functions of the immune system; normal cell growth; digestive, bowel, bladder, neurological, brain, respiratory, circulatory, endocrine and reproductive functions; or
2. You have an impairment that is in remission or substantially limits you occasionally (rather than constantly), but if it were active, it would substantially limit you as defined above; or
3. You have a record or history of having a physical and/or mental impairment that substantially limits one or more major life activities, as described above."¹

With an RA diagnosis and documentation of your medical history, you may meet one or more of these three criteria (even if you are in remission, you may consider acquiring accommodations should RA resurface mid school year per #2). Keep in mind that, "An institution of higher learning, such as a college or university, determines whether or not an impairment 'substantially limits' a major life activity on a case-by-case basis."²

In your first meeting with the counselor/advisor, you will likely discuss eligibility, required documentation, and potential accommodations for your specific program and situation. After you have provided the requisite documentation and are granted accommodations, you will receive confidential letters to give to each of your professors.

What type of accommodations can you receive?

This will vary depending on your program, the severity of RA, and the type of limitations you have. In my case, the accommodations granted were a relaxed attendance policy, negotiation of assignment due dates, a ten-minute break per hour should I need to go for a walk to relieve discomfort and permission to alternate between standing at the back of the room and sitting at the desk.

This was tremendously helpful, as many of my courses were three hours long. When in the midst of a flare, it was unbearable to remain seated in the same position. Likewise, though I rarely missed class, the relaxed attendance policy was a tremendous boon during a crucial moment of treatment when I was violently ill and abjectly miserable.

Follow-up thoughts on receiving accommodations

Professors tend to be people who love education, enjoy class time, and are eager and curious learners. They will expect similar attitudes from their students and will be wary of anyone who misuses accommodations. At the same time, teachers are required to uphold the accommodations granted by your institution, and you have legal recourse should you be discriminated against or not offered what is stated in your accommodations letter. It is expected that you will use accommodations only as necessary just as it is expected that teachers will adhere to them.

My personal recommendation is to be eager, engaged, on top of your coursework, and to promptly communicate about any accommodations that require your professor's involvement. For example, should you have a relaxed attendance policy, contact your professor if you know you will be missing class, or shortly after having missed. Do not miss a string of classes and weeks later send a note saying it was for accommodations. Respectfully keep the professor in the loop. For something like additional break time, I would recommend having a courteous conversation with each of your professors to work out how to do so with minimal interruption for fellow students.

Privacy and disclosure

Accommodations are confidential; you do not need to tell your professors why you have them. Perhaps you still feel like you should, or that it would be respectful to do so. Or, what if a teacher steps way out of line and asks? Ultimately disclosure is up to you. If a professor pressures you and you do not wish to share, contact your counselor immediately to rectify the situation.

As a student, I often thought I should tell my professors about RA and the reasons for my accommodations. After all, they would occasionally see me limp into class, get up with a grimace on my face and go for a short walk, or stare at my swollen hands while making very slow movements with a pen or keyboard. When I first taught a college course, however, I realized how superfluous such a thing is. Though all professors vary in the astuteness of their observations, if you show visible signs of discomfort and pain during class like I did, they will understand that it likely goes with the need for accommodations. Without speaking, you have shared plenty.

Regardless of how visible or invisible rheumatoid arthritis is for you, I would recommend always referring to your specific accommodations in communication rather than specifics about the illness. For instance, if you are in the midst of intense pain due to a disease flare and will need to miss class (assuming there is an attendance policy), email your professor something like, "Due to the nature of my circumstances, I will need to rely on my accommodations for an excused absence on (...). I will get notes from a fellow classmate and be up to date on the reading when I return. Please let me know of any additional materials or coursework to the syllabus that I might miss. Thank you for your time and consideration." This type of email demonstrating an attitude of responsibility and foresight will speak volumes about your commitment to class while protecting your right to privacy.

Concluding thoughts

Schedule an appointment with an accommodations adviser/counselor at the beginning of the school year to determine your eligibility and what can be offered. The caseload of the adviser in the early semester may be heavy, so plan ahead for a possible wait of a week or more. Likewise, let your doctor's office know promptly what documents you will need. Do not wait until after RA has interrupted your studies to seek accommodations. Likewise, depending on the policy of your school, accommodations may require renewal every semester or every academic year, so stay on top of it.

Finally, enjoy your time as student and be daring and bold in your education. Though RA can make the process more difficult, college is an amazing opportunity. Accommodations are there to help you achieve, not to brand you with guilt or shame. Use what resources are offered so you can do your absolute best, and be proud of your academic ability in the face of additional difficulties.